Provider Demographics
NPI:1598468779
Name:XU, HUANZHEN PSYCHE (PHD)
Entity Type:Individual
Prefix:DR
First Name:HUANZHEN
Middle Name:PSYCHE
Last Name:XU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:PSYCHE
Other - Middle Name:
Other - Last Name:XU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:526 SUPERIOR AVE E STE 108D
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1907
Mailing Address - Country:US
Mailing Address - Phone:216-800-4725
Mailing Address - Fax:
Practice Address - Street 1:526 SUPERIOR AVE E STE 108D
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-1907
Practice Address - Country:US
Practice Address - Phone:216-800-4725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08448103TC0700X, 103TH0004X, 103TH0100X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service